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To the Editor.—
Drs Kapdi and Wolfe are competent radiologists, but they missed one of the fundamentals of scientific research. They failed to use suitable controls. In their opening paragraph, they state that "a definite relationship between breast cancer and hypothyroidism has been established." This is certainly true, and the most convincing evidence for it are some personal, unpublished observations on the routine autopsies performed in Graz, Austria. Graz is a goiter area; the entire population suffers from a relative thyroid deficiency. Thyroid replacement is rarely employed there. Yet the incidence of breast cancer is as high as ten times that seen in the United States. If thyroid deficiency can predispose to breast cancer, the influence of thyroid therapy in the etiology of the cancer could only be measured by comparing the incidence in a group of untreated hypothyroid patients with that in a group receiving thyroid replacement. Comparing the
Barnes BO. Thyroid Supplements and Breast Cancer. JAMA. 1976;236(24):2743–2744. doi:10.1001/jama.1976.03270250013005
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